NPIMap

Organization Active NPI

Licensed2Listen

  • Community/Behavioral Health Agency
  • Longview, WA
National Provider Identifier
1609168889
Registry record updated Jun 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
LF 603008337 Issued in WI
Legal business name
LICENSED2LISTEN
Practice address
1339 Commerce Ave
Suite 305
Longview, WA 98632-5347
Phone
(360) 703-7171
NPI assigned
May 6, 2011
Last updated
Jun 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Colette Annette Giovanniello, M.A., LMFTNPI 1497865737
Title
Marriage and Family Therapist
Phone
(360) 703-7171

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X LF 603008337 WI Primary

Addresses

Primary practice location

1339 Commerce Ave
Suite 305
Longview, WA 98632-5347

Mailing address

1339 Commerce Ave
Suite 305
Longview, WA 98632
Phone (360) 703-7171

Other identifiers 2

IdentifierTypeStateIssuer
603008337OtherWAUBI TAX IDENTIFICATION
G869183VOtherWAPAC CODE

National Provider Directory

National Provider Directory

Locations

1339 Commerce Ave
Ste 305
Longview, WA 98632
Phone (360) 703-7171

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1304640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307577600000",
    "number": "1609168889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1339 COMMERCE AVE",
            "address_2": "SUITE 305",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "98632",
            "telephone_number": "360-703-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1339 COMMERCE AVE",
            "address_2": "SUITE 305",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986325347",
            "telephone_number": "360-703-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LICENSED2LISTEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-06",
        "last_updated": "2011-06-09",
        "status": "A",
        "authorized_official_last_name": "GIOVANNIELLO",
        "authorized_official_first_name": "COLETTE",
        "authorized_official_middle_name": "ANNETTE",
        "authorized_official_title_or_position": "MARRIAGE AND FAMILY THERAPIST",
        "authorized_official_telephone_number": "360-703-7171",
        "authorized_official_credential": "M.A., LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "LF 603008337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBI TAX IDENTIFICATION",
            "identifier": "603008337",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PAC CODE",
            "identifier": "G869183V",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.